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Laboratory Testing: Reflecting Our Changing Society

As laboratory professionals, our focus on quality begins by looking inward at our operational processes — from specimen collection to result reporting. But the application of this work is then externalized, sent to the ordering physicians and applied to their patients. The way we perform and report our work and its effect on patient care ultimately affects the greater community. This we already know, and it is one of our strongest motivators to maintain the best quality possible. What we may not see as clearly is how changes in the world around us are constantly impacting our own work environment, challenging established routines and time tested views of our profession.

While change brings up thoughts of new tests, new instruments, new procedures and more training, it can also require conceptual re-orientation of what we are achieving. An example of this is the emergence of genomics and genetic testing, enabling the rise of personalized medicine. Our test results contribute to the development of individualized treatment protocols

But we also live in an era where laboratory testing has become intertwined with political, social and technological change to a degree unheard of in years past. Laboratory testing has always been in the epicenter of efforts to control and monitor disease outbreaks, such as HIV (with all the attendant societal issues surrounding it). Now, we are in the midst of an epidemic of illicit drug usage, particularly prescription pain killers like opioids and opiates.

This category of laboratory testing is the fastest growing not only in the United States, but in the UK, Japan, Germany and other European countries. Illicit drug users now exceed 315 million globally, approximately 6.9% of the global adult population. Imagine the unmet need for additional laboratory testing: drug screening, confirmation and monitoring. Progress in dealing with this epidemic cannot be made unless our work is accurate and reliable.

Additionally, we cannot help but be part of preparation and planning regarding the possibility of bioterrorism. Whether we are in public health, the hospital, the physician office or reference laboratories, we will be involved. Our concerns range from disseminated Anthrax to Yersinia pestis (plague) to everything in-between. The importance of the quality of our work extends far beyond immediate patient treatment to a new and higher societal level.

About The Author

Irwin is Quality Advisor for COLA Resources, Inc (CRI®). where he provides a wide range of technical assistance to laboratories across the country. He previously held the position of Executive Director at Community Response, a community-based organization that provides HIV/AIDS support services in metropolitan Chicago. Prior to that position he was the Laboratory Manager of Crittenden Memorial Hospital, West Memphis, AR.
He holds a Bachelor of Science degree from Brooklyn College, a Medical Technology degree from Good Samaritan School of Medical Technology, a Master of Science degree from Colorado State University, and a Master of Business Administration degree from the University of Memphis.

Without quality systems in the clinical laboratory, diagnosis can be a crap shoot. No test is better than a test that yields an incorrect value & sends the physician down a bunny trail looking for something that is not there.